Colorectal

Colorectal Surgery is a surgical subspecialty that manages a variety of benign and malignant conditions such as diverticulitis, colon, rectal and anal cancer, inflammatory bowel disease such as Crohn and Ulcerative colitis, or a wide spectrum of perianal disease such as anal fistula, fissure and hemorrhoids, as well as pelvic floor diseases such as rectal prolapse and fecal incontinence. A colorectal surgeon can perform minimally invasive surgery with the use of robot or laparoscope as well as open surgical procedures. The choice of which approach depends on many factors determined case by case.

Colon and Rectal Cancer

Colon cancer is a cancer that begins in the large intestine, which is the last part of the digestive system. In its early stages, colon cancer may not cause any symptoms. Surgery is one of the most effective treatment options for colon cancer. 

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Inflammatory Bowel Disease (IBD)

Inflammatory bowel disease (IBD) is a wide spectrum of chronic inflammatory conditions that involve the digestive system, there are two main types. Ulcerative colitis: Which mainly involved large bowel (Colon and Rectum). Crohn’s disease: This affects any part of the digestive system.
Both diseases usually presented with severe diarrhea, abdominal pain, fatigue, weight loss, and many other symptoms.
To confirm the diagnosis of IBD your doctor will request a blood test, procedures such as colonoscopy, and images such as CT scan.
Treatment of IBD depends on the severity of the disease, most of the time treatment will be provided by your gastroenterologist in the form of antibiotic, anti-inflammatory, or immune-suppressive drugs. Surgeons get involved either to treat complications or if medical treatment fails to control the disease.

Pelvic Floor Disorders

The pelvic floor consists of a group of muscles that provide support to pelvic organs (bladder, rectum, and uterus or prostate). Contracting and relaxing these muscles allows you to control your bowel movements, urination, and, for women particularly, sexual intercourse.
Damage and aging of these muscles lead to a variety of issues, such as fecal and urine incontinence, rectum, bladder, and uterus prolapse.
Treatment includes pelvic floor physical therapy and/or surgery depends on what condition to treat. For instance, fecal incontinence is best treated with sacral nerve stimulator on an outpatient basis, but rectal prolapse may need robotic surgery.

Hemorrhoids

Hemorrhoids are swollen veins in your anus and lower rectum, similar to varicose veins. Hemorrhoids can develop inside the rectum (internal hemorrhoids) or under the skin around the anus (external hemorrhoids).
Most of the time patients complain of Itching or irritation in the anal region, pain or discomfort, swelling around the anus, or bleeding.
Modifying lifestyle measures can prevent and improve an existing disease, such as eating a high-fiber diet, drinking plenty of fluids, avoiding strain and long periods of sitting.
Treatment includes the above measures as well as the use of local topical treatments. Soak regularly in a warm bath or sitz bath. Take oral pain relievers.
If symptoms are persistent such as bleeding or pain, your doctor might recommend surgery. These procedures can be done in the office (Rubber banding) or in an outpatient setting under anesthesia (Hemorrhoidectomy)

Anal Fistula

A small tunnel under the skin communicating the rectum with the outside, it usually develops after infection in the perianal area. There are many types of fistula based on how much sphincter muscle involved. For example, superficial fistula does not involve any sphincter muscle and it is a simpler form and easier to take care of. However, trans-sphincteric fistula involves both internal and external sphincter muscle and therefore, it is the most complex form of fistula and has a high recurrence rate.
Anal fistula requires surgery to cure it. There are many types of surgeries depending on which type of fistula you have.

Diseases

  • Colon cancer
  • Rectal cancer
  • Anal cancer
  • Familial Adenomatous polyposis
  • Lynch Syndrome
  • GIST
  • Anal Condyloma
  • Anal Intraepithelial neoplasia
  • Small bowel cancer
  • Diverticular disease
  • Ulcerative colitis
  • Crohn disease
  • Hemorrhoids
  • Anal Fissure
  • Anorectal abscess and Fistula
  • Hidradenitis Suppurative
  • Pilonidal Disease
  • Rectal prolapse
  • Incontinence
  • Parastomal hernia
  • Stoma prolapse
  • Chronic constipation
  • Pelvic floor disorders

Procedures

  • Open, laparoscopic and robotic partial and total colectomy
  • Open, laparoscopic and robotic low anterior resection
  • Open and robotic abdominoperineal resection
  • Transanal minimal invasive surgery for rectal cancer and precancer lesions
  • Mucosal advancement flap
  • Seton placement
  • Sphincterotomy
  • Laparscopic and Robotic Rectopexy
  • Perineal Proctosigmoidectomy (Altemeier procedure)
  • Sacral nerve stimulator implant
  • Karydakis flap procedur for pilonidal disease
  • High resolution anoscopy
  • Hemorrhoidecotmy
  • Rubber band ligation
  • Transanal Hemorrhoidal Dearterilization
  • Fistulotomy
  • Ligation of intersphincteric fistula
  • Incisional hernia repair with and without mesh
  • Parastomal hernia repair with and without mesh
  • Stoma prolapse repair